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Socioeconomic deprivation and the clinical management of self-harm: a small area analysis

Research output: Contribution to journalArticle

Original languageEnglish
Pages (from-to)1475–1481
Number of pages7
JournalSocial Psychiatry and Psychiatric Epidemiology
Issue number12
Early online date4 Oct 2017
DateAccepted/In press - 17 Aug 2017
DateE-pub ahead of print - 4 Oct 2017
DatePublished (current) - Dec 2017


Purpose: Socioeconomic deprivation is associated with increased rates of self-harm but its association with levels of clinical care has not previously been explored. The aim of the current study was to investigate socioeconomic differences in the clinical management of people who self-harm.
Method: Cross-sectional analysis of 3607 people presenting to a large inner-city hospital following self-harm.
Results: People from the least deprived quintile were more likely to receive a psychosocial assessment (most vs. least deprived: 63.51% vs. 70.14%). This effect persisted in our fully adjusted model (OR 1.45, CI 1.15-1.82, p=0.002). Mediation analysis suggested this association was in large part explained by higher rates of selfdischarge in people presenting from areas of higher deprivation.
Conclusions: Compared to those from more deprived areas, people from less deprived areas are more likely to receive a psychosocial assessment when presenting to hospital following self-harm. The occurrence of higher rates of self-discharge from emergency departments among those from more deprived areas may explain the association.

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